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Preventing Chronic Whiplash Pain

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Dennis Turk, University of Washington
ClinicalTrials.gov Identifier:
NCT00021476
First received: July 16, 2001
Last updated: August 9, 2013
Last verified: August 2013

July 16, 2001
August 9, 2013
May 2001
February 2007   (final data collection date for primary outcome measure)
  • Pain [ Time Frame: Measured 3 months after the accident ] [ Designated as safety issue: No ]
  • Functional activity [ Time Frame: Measured 3 months after the accident ] [ Designated as safety issue: No ]
  • Mood [ Time Frame: Measured 3 months after the accident ] [ Designated as safety issue: No ]
Not Provided
Complete list of historical versions of study NCT00021476 on ClinicalTrials.gov Archive Site
  • Fear avoidance [ Time Frame: Measured 3 months after the accident ] [ Designated as safety issue: No ]
  • Range of motion/strength [ Time Frame: Measured 3 months after the accident ] [ Designated as safety issue: No ]
  • Physical symptoms [ Time Frame: Measured 3 months after the accident ] [ Designated as safety issue: No ]
Not Provided
Not Provided
Not Provided
 
Preventing Chronic Whiplash Pain
Preventing Chronic Whiplash Pain: Biobehavioral Approach

This study is aimed at developing ways to prevent acute pain from becoming chronic pain--specifically, pain associated with whiplash-associated disorders (WADs) from motor vehicle accidents. Research on the development of chronic pain due to musculoskeletal injury suggests that a person's initial emotional reactions, particularly fear of reinjury and subsequent avoidance of activity, contribute significantly to chronic pain and persistent disability. This study will treat people with WADs during the first three months after a motor vehicle accident with a behavioral and physical exercise program designed to encourage activity and discourage continued fear of movement, pain, and disability. The study will compare the effectiveness of two anxiety-reduction treatments to standard care in reducing pain and activity limitations in people with WADs in the 2 to 3 months after motor vehicle accidents.

More than 1.8 million people in the United States suffer from chronic pain and disability following motor vehicle accidents (MVAs) each year. The majority of these cases start with a relatively minor neck injury. The Quebec Task Force Study on Whiplash Associated Disorders (WAD) was created in 1989 to determine the clinical, public health, social, and financial determinants of WAD. Multiple studies have described the clinical features of WAD, which include neck, shoulder, arm, low back, and head pain; tinnitus; visual symptoms; dizziness; temporomandibular joint pain; and paraesthesias. Onset of these symptoms after the injury is usually delayed for several hours and worsens within 24 to 48 hours. Neck pain is the most frequent symptom, and between 14% and 42% of patients with WAD develop chronic neck pain symptoms. Studies suggest that the neck pain will either resolve in the first few months or persist indefinitely. One variable that may predict outcome after an MVA is the acute emotional response immediately after the MVA.

A severe emotional reaction accompanied by neck pain and stiffness after an MVA could lead an injured person to avoid subsequent physical activity through such mechanisms as fear avoidance and fear of reinjury. Research investigating the evolution of chronic pain due to musculoskeletal injury suggests that initial emotional reactivity, particularly fear of reinjury and subsequent activity avoidance, contributes significantly to unremitting pain and persistent disability. Research based on this model has shown that early interventions targeting normalization of excessive emotionality and restriction of activities associated with fear following injury effectively prevent chronic pain due to back injury. No previous study has sought to intervene during the first three months after an MVA with a behavioral and physical exercise program to encourage activity and discourage continued fear of movement, pain and disability.

This study consists of two primary components: (1) To compare the effectiveness of two anxiety-reduction treatments with standard care in reducing pain and activity limitations in patients with WADs 2 to 3 months following MVAs. (2) To test whether psychological responses to the initial trauma, such as fear avoidance, fear of injury, and negative affectivity, discriminate between symptomatic WAD patients and WAD sufferers whose symptoms had resolved 2 to 3 months post-MVA.

Interventional
Phase 3
Allocation: Randomized
Endpoint Classification: Safety Study
Intervention Model: Single Group Assignment
Masking: Single Blind
Primary Purpose: Prevention
Whiplash Injuries
  • Behavioral: Behavioral treatments
  • Behavioral: Physical therapy
Not Provided
Robinson JP, Theodore BR, Dansie EJ, Wilson HD, Turk DC. The role of fear of movement in subacute whiplash-associated disorders grades I and II. Pain. 2013 Mar;154(3):393-401. doi: 10.1016/j.pain.2012.11.011. Epub 2012 Dec 1.

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
300
February 2007
February 2007   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • Have whiplash injury following a motor vehicle accident in the prior 4 to 10 weeks
Both
20 Years to 65 Years
No
Contact information is only displayed when the study is recruiting subjects
United States
 
NCT00021476
R01 AR47298, R01AR047298, NIAMS-064
Not Provided
Dennis Turk, University of Washington
University of Washington
Not Provided
Principal Investigator: Dennis C. Turk, PhD University of Washington
University of Washington
August 2013

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP